Patient Financial Advocate-SF

Presbyterian Healthcare Services•Santa Fe, NM

4d•$17 - $28•Onsite

About The Position

Performs financial screening on hospital and medical group account activity to identify residual balances, high-deductible plan participants and self-pay patients. Requires thorough knowledge of assistance programs to include charity care application, Medicaid (PEMOSSA) application and other alternate resource programs in addition to full competency of Presbyterians policy for payment plan application. In depth understanding of benefits administration of PHS contracts and their respective in and out of network arrangements. This role requires comprehension of the pre-billing/pre-adjudication of claim filing to successfully identify out of pocket expense the patient should anticipate. Possess a broad understanding of Presbyterians affiliates and their billing methodologies. Successfully counsel patients and/or families regarding financial responsibilities to Presbyterian. Ability to use standardized procedures that emphasize assertive steps to resolve and gain reimbursement of patient financial obligatory amounts using CARES Behaviors. Ability to research disputed account balances and resolve accounts with outstanding residual balances. Escalates chronic no pay or bad debt accounts to superior. Demonstrates a commitment to Presbyterians Sense of Mission by role modeling CARES Behaviors and appropriate customer service techniques to perform patient education and act as a resource and advocate to our patients and members.

Requirements

Three to five years of experience in healthcare field with significant MD and patient interaction required.
Must be able to demonstrate competency in registration with the ability to pass all Epic competencies within 30 days of hire
Candidates must be at least 18 years of age at the time of hire

Nice To Haves

Physician office or hospital experience preferred.
Prior billing office and collection experience preferred.

Responsibilities

Calculate patient out of pocket expectation (co-insurance, co-payment, deductible, residual amounts) and alert patient to that balance prior to upcoming visit.
Use coding knowledge to calculate charges for more complicated levels of service (modifiers, lesions, etc).
Contact patient to set the expectation for payment during the visit.
Offer an appointment to review account when questions exist.
Successful collection rate of residual, high-deductible and self pay amounts in a courteous, professional manner using CARES Behaviors.
Exceptional registration accuracy skills to identify errors and correct them as necessary.
Serves as a resource to staff regarding account interpretations.
Identify claims where filing errors have occurred and resubmit the claims to payors for consideration.
Demonstrated competence in using patient estimator technology and on line tools available to provide a reasonably accurate out of pocket expense expectation for patients and their guarantors.
Facilitates the operations of the clinic or hospital by providing support to clerical staff to discuss account activity with patients and guarantors.
Communicates appropriate situations to Clinic Manager , DPO, and Patient Access Supervisor.
Keeps current on PHS financial policies, including payment plans, programs and other forms of funding.
Comprehension of billing methodology for an integrated delivery system to include lab and other ancillary services in scope.
Responsible for covering other POB/PMG clerical operations duties based on business need
Other duties as assigned.